Healthcare Provider Details

I. General information

NPI: 1558782243
Provider Name (Legal Business Name): TREYEYES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2013
Last Update Date: 12/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2391 S WAYSIDE DR
HOUSTON TX
77023-3910
US

IV. Provider business mailing address

2391 S WAYSIDE DR
HOUSTON TX
77023-3910
US

V. Phone/Fax

Practice location:
  • Phone: 713-300-3657
  • Fax: 832-934-1161
Mailing address:
  • Phone: 713-300-3657
  • Fax: 832-934-1161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: GERARD H STAFFORD
Title or Position: OD/OWNER
Credential: OD
Phone: 832-934-1166